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PEP Approach...

The Portfolio Eating Plan (PEP) is a dietary approach to manage cholesterol levels. The diet was developed because of the National Heart Lung and Blood Institute recommendation for diet and lifestyle changes as the first course of action for those with elevated cholesterol levels and for a realistic and manageable dietary option for those looking to do so.1Patterned after the National Cholesterol Education Program (NCEP) step II diet, which recommends less than 7 percent of calories from saturated fat; less than 200 mg cholesterol, the PEP intervention diet adds the following components each day as part of a 2,000 calorie diet:2,3

• Nuts: either 30 grams (about 1 ounce or 23) almonds or 45 grams (about 1.5 ounces) of nuts, including almonds, depending on the phase of the PEP study
• Fiber: 20 grams (less than one ounce) of viscous fiber from foods such as oats, barley, and certain fruits and vegetables
• Soy: 80 grams of soy protein from foods such as tofu, soy meat alternatives, and soy milk
• Plant Sterols: 2 grams (.064 ounces) of plant sterols from spreads, such as Benecol® or Take Control®
Participants were instructed to meet the daily fruit and vegetable recommendation of five to nine servings. Further, while they were encouraged to follow a vegetarian diet, later phases of the study, including the most recent, were relaxed to include all foods.

1 U.S. Department of Health and Human Services. National Heart, Lung and Blood Institute. Third Report of the Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Accessed at: http://www.nhlbi.nih.gov/guidelines/cholesterol/index.htm
2 Jenkins DJ, Kendall CW, Marchie A, et al. Effects of a dietary portfolio of cholesterol-lowering foods vs lovastatin on serum lipids and C-reactive protein. JAMA. 2003;290(4):502-510.
3 Jenkins, DA, et al. Effect of a Dietary Portfolio of Cholesterol-Lowering Foods Given at 2 Levels of Intensity of Dietary Advice on Serum Lipids in Hyperlipidemia. JAMA. 2011;306[8]:831-839.